BACKGROUND: Allergy to insects is common. However, few reports cover occupational sensitization to flour moth (Ephestia [syn. Anagasta] kuehniella). We describe a baker who suffered from IgE-mediated occupational respiratory allergy to flour moth. METHODS: The skin prick test (SPT) and serum IgE tests were used to evaluate the patient's sensitivity to flour moth. Allergen cross-reactivity with mites was evaluated in IgE-inhibition studies. Clinical sensitivity was evaluated by nasal challenge test. Pulmonary function tests were repeatedly monitored. RESULTS: SPT with flour moth gave a 6-mm wheal, and an elevated level of flour moth-specific IgE was measured in the patient's serum (1.9 PRU/ml, RAST class 2). Immunoblotting with the patient's serum revealed at least seven heavy IgE-binding bands with molecular masses of 22, 35, 43, 53, 65, 77, and >86 kDa in the extract of flour moth. Allergen cross-reactivity with mites was demonstrated in inhibition studies. Immediate-type allergy to flour moth was confirmed by nasal challenge. Increased daily variability of PEF values was observed during workplace exposure. CONCLUSION: A baker's occupational respiratory allergy to flour moth was confirmed.
BACKGROUND:Allergy to insects is common. However, few reports cover occupational sensitization to flour moth (Ephestia [syn. Anagasta] kuehniella). We describe a baker who suffered from IgE-mediated occupational respiratory allergy to flour moth. METHODS: The skin prick test (SPT) and serum IgE tests were used to evaluate the patient's sensitivity to flour moth. Allergen cross-reactivity with mites was evaluated in IgE-inhibition studies. Clinical sensitivity was evaluated by nasal challenge test. Pulmonary function tests were repeatedly monitored. RESULTS: SPT with flour moth gave a 6-mm wheal, and an elevated level of flour moth-specific IgE was measured in the patient's serum (1.9 PRU/ml, RAST class 2). Immunoblotting with the patient's serum revealed at least seven heavy IgE-binding bands with molecular masses of 22, 35, 43, 53, 65, 77, and >86 kDa in the extract of flour moth. Allergen cross-reactivity with mites was demonstrated in inhibition studies. Immediate-type allergy to flour moth was confirmed by nasal challenge. Increased daily variability of PEF values was observed during workplace exposure. CONCLUSION: A baker's occupational respiratory allergy to flour moth was confirmed.